Annual Trend of Neonatal Mortality and Its Underlying Causes: Populational Study – SÃO Paulo State, Brazil, 2004-2013

Abstract Background: Populational studies analyzing neonatal deaths in middle-income countries may contribute to design interventions to achieve the Sustainable Development Goals, established by United Nations. This study goal is to analyze the annual trend of neonatal mortality in São Paulo State, Brazil, over a 10-year period and its underlying causes and to identify maternal and neonatal characteristics at birth associated with neonatal mortality.Method: Populational study of births and deaths from 0-27 days between 2004-2013 in São Paulo State, Brazil. The annual trend of neonatal mortality rate according to gestational age was analyzed by Poisson or by Negative Binomial Regression models. Basic causes of neonatal death were classified according to ICD-10. Association of maternal demographic variables (block 1), prenatal and delivery care variables (block 2), and neonatal characteristics at birth (block 3) with neonatal mortality was evaluated by Poisson regression analysis adjusted by year of birth. Results: Among 6,056,883 live births in São Paulo State during the study period, 48,309 died from 0-27 days (neonatal mortality rate: 8.0/1,000 live births). For the whole group and for infants with gestational age 22-27, 28-31, 32-36, 37-41 and ≥42 weeks, reduction of neonatal mortality rate was, respectively, 18%, 15%, 38%, 53%, 31%, and 58%. Median time until 50% of deaths occurred was 3 days. Main basic causes of death were respiratory disorders (25%), malformations (20%), infections (17%), and perinatal asphyxia (7%). Variables independently associated with neonatal deaths were maternal schooling, prenatal care, parity, newborn sex, 1st minute Apgar, and malformations. Cesarean delivery, compared to vaginal, was protective against neonatal mortality for infants at 22-31 weeks, but it was a risk factor for those with 32-41 weeks.Conclusion: Despite the significant decrease in neonatal mortality rate over the 10-year period in São Paulo State, improved access to qualified health care is needed in order to avoid preventable neonatal deaths and increase survival of infants that need more complex levels of assistance.

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Annual trend of neonatal mortality and its underlying causes: population-based study – São Paulo State, Brazil, 2004–2013

BMC Pediatrics ◽

10.1186/s12887-021-02511-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ruth Guinsburg ◽

Adriana Sanudo ◽

Carlos Roberto V Kiffer ◽

Ana Sílvia S Marinonio ◽

Daniela T Costa-Nobre ◽

...

Keyword(s):

Mortality Rate ◽

Neonatal Mortality ◽

Population Based ◽

Sao Paulo ◽

São Paulo ◽

Neonatal Mortality Rate ◽

Neonatal Deaths ◽

Annual Trend ◽

Paulo State ◽

São Paulo State

Abstract Background Population-based studies analyzing neonatal deaths in middle-income countries may contribute to design interventions to achieve the Sustainable Development Goals, established by United Nations. This study goal is to analyze the annual trend of neonatal mortality in São Paulo State, Brazil, over a 10-year period and its underlying causes and to identify maternal and neonatal characteristics at birth associated with neonatal mortality. Method A population-based study of births and deaths from 0 to 27 days between 2004 and 2013 in São Paulo State, Brazil, was performed. The annual trend of neonatal mortality rate according to gestational age was analyzed by Poisson or by Negative Binomial Regression models. Basic causes of neonatal death were classified according to ICD-10. Association of maternal demographic variables (block 1), prenatal and delivery care variables (block 2), and neonatal characteristics at birth (block 3) with neonatal mortality was evaluated by Poisson regression analysis adjusted by year of birth. Results Among 6,056,883 live births in São Paulo State during the study period, 48,309 died from 0 to 27 days (neonatal mortality rate: 8.0/1,000 live births). For the whole group and for infants with gestational age 22–27, 28–31, 32–36, 37–41 and ≥ 42 weeks, reduction of neonatal mortality rate was, respectively, 18 %, 15 %, 38 %, 53 %, 31 %, and 58 %. Median time until 50 % of deaths occurred was 3 days. Main basic causes of death were respiratory disorders (25 %), malformations (20 %), infections (17 %), and perinatal asphyxia (7 %). Variables independently associated with neonatal deaths were maternal schooling, prenatal care, parity, newborn sex, 1st minute Apgar, and malformations. Cesarean delivery, compared to vaginal, was protective against neonatal mortality for infants at 22–31 weeks, but it was a risk factor for those with 32–41 weeks. Conclusions Despite the significant decrease in neonatal mortality rate over the 10-year period in São Paulo State, improved access to qualified health care is needed in order to avoid preventable neonatal deaths and increase survival of infants that need more complex levels of assistance.

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Neonatal mortality associated with perinatal asphyxia: a population-based study in a middle-income country

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03652-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mandira D. Kawakami ◽

Adriana Sanudo ◽

Mônica L. P. Teixeira ◽

Solange Andreoni ◽

Josiane Q. X. de Castro ◽

...

Keyword(s):

Neonatal Mortality ◽

Gestational Age ◽

Perinatal Asphyxia ◽

Population Based ◽

Sao Paulo ◽

São Paulo ◽

Middle Income ◽

Neonatal Deaths ◽

Paulo State ◽

São Paulo State

Abstract Background It is challenging to decrease neonatal mortality in middle-income countries, where perinatal asphyxia is an important cause of death. This study aims to analyze the annual trend of neonatal mortality with perinatal asphyxia according to gestational age in São Paulo State, Brazil, during a 10-year period and to verify demographic, maternal and neonatal characteristics associated with these deaths. Methods Population-based study of neonatal deaths associated with perinatal asphyxia from 0 to 27 days in São Paulo State, Brazil, from 2004 to 2013. Perinatal asphyxia was considered as associated to death if intrauterine hypoxia, birth asphyxia or neonatal aspiration of meconium were noted in any line of the Death Certificate according to ICD-10. Poisson Regression was applied to analyze the annual trend of neonatal mortality rate according to gestational age. Kaplan-Meier curve was used to assess age at death during the 10-year study period. Hazard ratio of death during the neonatal period according to gestational age was analyzed by Cox regression adjusted by year of birth and selected epidemiological factors. Results Among 74,002 infant deaths in São Paulo State, 6648 (9%) neonatal deaths with perinatal asphyxia were studied. Neonatal mortality rate with perinatal asphyxia fell from 1.38‰ in 2004 to 0.95‰ in 2013 (p = 0.002). Reduction started in 2008 for neonates with 32–41 weeks, in 2009 for 28–31 weeks, and in 2011 for 22–27 weeks. Median time until 50% of deaths occurred was 25.3 h (95%CI: 24.0; 27.2). Variables independently associated with higher risk of death were < 7 prenatal visits, 1st minute Apgar score 0–3, and death at the same place of birth. Cesarean delivery compared to vaginal was protective against death with perinatal asphyxia for infants at 28–36 weeks. Conclusions There was an expressive reduction in neonatal mortality rates associated with perinatal asphyxia during this 10-year period in São Paulo State, Brazil. Variables associated with these deaths highlight the need of public health policies to improve quality of regionalized perinatal care.

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Altitudinal and geographic effects on communities of euglossine bees (Hymenoptera: Apidae) in three different phytophysiognomies of the Atlantic Forest of São Paulo State, Brazil

10.1603/ice.2016.110300 ◽

2016 ◽

Author(s):

Claudineia Pereira Costa

Keyword(s):

Atlantic Forest ◽

Sao Paulo ◽

São Paulo ◽

Euglossine Bees ◽

Paulo State ◽

São Paulo State ◽

Geographic Effects

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Implantação da Residência Médica e Multiprofssional em Saúde da Família em um município paulista: percepção de residentes da primeira turma (2014-2016)

Revista Brasileira de Pesquisa em Saúde/Brazilian Journal of Health Research ◽

10.21722/rbps.v19i2.18868 ◽

2018 ◽

Vol 19 (2) ◽

pp. 106-114 ◽

Cited By ~ 1

Author(s):

Liliane Maria Guimarães de Pinho ◽

Vera Lúcia Garcia ◽

Maria Cezira Fantini Nogueira-Martins

Keyword(s):

Family Health ◽

Sao Paulo ◽

São Paulo ◽

Paulo State ◽

São Paulo State

Implementation of a multiprofessional residency in family health in a city of São Paulo state: perception of the first residents (2014-2016)

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Arsenic in terrestrial invertebrates from riparian areas of the Piracicaba River Basin, São Paulo State, Brazil

Journal of Radioanalytical and Nuclear Chemistry ◽

10.1007/s10967-017-5606-2 ◽

2017 ◽

Vol 314 (3) ◽

pp. 1675-1681

Author(s):

Elvis J. França ◽

Elisabete A. De Nadai Fernandes ◽

Felipe Y. Fonseca ◽

Marcelo R. L. Magalhães ◽

Mariana L. O. Santos

Keyword(s):

River Basin ◽

Sao Paulo ◽

São Paulo ◽

Riparian Areas ◽

Terrestrial Invertebrates ◽

Paulo State ◽

São Paulo State ◽

Piracicaba River

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Occurrence of caffeine, fluoxetine, bezafibrate and levothyroxine in surface freshwater of São Paulo State (Brazil) and risk assessment for aquatic life protection

Environmental Science and Pollution Research ◽

10.1007/s11356-020-11799-5 ◽

2021 ◽

Author(s):

Raquel Cardoso de Souza ◽

Aline Andrade Godoy ◽

Fábio Kummrow ◽

Thyago Leandro dos Santos ◽

Carlos Jesus Brandão ◽

...

Keyword(s):

Risk Assessment ◽

Sao Paulo ◽

São Paulo ◽

Aquatic Life ◽

Paulo State ◽

São Paulo State

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Perspectives under uncertainties and risk in wind farms investments based on Omega-LCOE approach: An analysis in São Paulo state, Brazil

Renewable and Sustainable Energy Reviews ◽

10.1016/j.rser.2021.110805 ◽

2021 ◽

Vol 141 ◽

pp. 110805

Author(s):

Giancarlo Aquila ◽

Wilson Toshiro Nakamura ◽

Paulo Rotella Junior ◽

Luiz Celio Souza Rocha ◽

Edson de Oliveira Pamplona

Keyword(s):

Wind Farms ◽

Sao Paulo ◽

São Paulo ◽

Paulo State ◽

São Paulo State

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A plant fossil assemblage of Lycopodiopsis cf. derbyi from the Corumbataí Formation, Paraná Basin, São Paulo State, Brazil

Palaeobiodiversity and Palaeoenvironments ◽

10.1007/s12549-020-00477-6 ◽

2021 ◽

Author(s):

Thaís Silvana de Carvalho ◽

Marcelo Adorna Fernandes ◽

Frésia Ricardi-Branco ◽

Aline Marcele Ghilardi ◽

Bernardo de Campos Pimenta e Marque Peixoto ◽

...

Keyword(s):

Sao Paulo ◽

São Paulo ◽

Fossil Assemblage ◽

Paulo State ◽

Plant Fossil ◽

Paraná Basin ◽

São Paulo State ◽

Parana Basin

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Regional Distance Routes Estimation for Municipal Solid Waste Disposal, Case Study São Paulo State, Brazil

Energies ◽

10.3390/en14133964 ◽

2021 ◽

Vol 14 (13) ◽

pp. 3964

Author(s):

Laryssa Morais ◽

Victor Nascimento ◽

Silvio Simões ◽

Jean Ometto

Keyword(s):

Municipal Solid Waste ◽

Solid Waste ◽

Greenhouse Gas Emission ◽

Regional Scale ◽

Sao Paulo ◽

Environmental Cost ◽

Population Increase ◽

São Paulo ◽

Paulo State ◽

São Paulo State

The urban population increase in the world, the economic expansion, and the rise in living standards associated with society’s habits and lifestyles accelerated the municipal solid waste (MSW) generation in undeveloped countries, such as in Brazil, in which the generation increased by 25% from 2012 to 2017. In the same period, the São Paulo state, the richest Brazilian state, increased its municipal solid waste generation by 51%. All this MSW needed to be collected and transported, and this process has a high economic and environmental cost. Therefore, this study aims to identify, using spatial analysis, the routes used by MSW trucks to estimate the distances traveled to dispose of the MSW on a regional scale considering all municipalities in the São Paulo state. The findings showed that the landfill numbers decrease, mainly individual ones, which receive MSW only from the city where it is located. Otherwise, the consortium landfills number is increasing, as well as the number of municipalities that share the same disposal site. Consequently, the distances to transport MSW from urban areas to final disposal sites increased by about 55% from 2012 to 2017, reaching 613 million kilometers during this period. This total distance is sufficient to make more than 12,806 laps on Earth and contribute to high fuel consumption and greenhouse gas emission.

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